Incorporating household structure into a discrete event simulation model of tuberculosis and HIV

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Description/Abstract

Human immunodeficiency virus (HIV) increases the risks of developing tuberculosis (TB) disease following
infection, and speeds up disease progression. This has had a devastating effect on TB epidemics in sub-Saharan
Africa, where incidence rates have more than trebled in the past twenty years. Current control methods for TB
disease have failed to keep pace with this growth in TB, and there is an urgent need to find TB control strategies
that are effective in high-HIV prevalent settings. This paper describes a discrete-event simulation model of
endemic TB that includes the effects of HIV and of household structure on the transmission dynamics of TB.
Incorporating a social structure allows us to compare the effectiveness of contact-tracing interventions with
targeted case-finding at high risk groups. We describe the modeling of the household structure in some detail, as
this has applications to the modeling of other infectious diseases.